رجل عمره ٦٠ سنة عنده سرطان رئة، صار عنده تورم في الوجه والرقبة والذراعين، وأوردة الصدر بارزة، وضيق نفس يزيد عند الاستلقاء. التشبع ٩٢٪. ما الأرجح؟

A 60-year-old with lung cancer develops swelling of the face, neck and arms, prominent chest veins and breathlessness worse lying flat. SpO2 92%. What is most likely?

1. Superior vena cava syndrome
2. A food allergy
3. Facial cellulitis
4. Simple right heart failure

Answer: A) Superior vena cava syndrome. Facial and arm swelling with distended chest veins in a thoracic tumour indicates SVC obstruction; raise the head, give oxygen and escalate for imaging and treatment.